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�_, <br /> w� � <br /> tr �, ,��' � � 5d�wRkT, ar� �iy. <br /> `, {� .,1 �w� �h3'''° � � , :: <br /> j M1..3 ,ry � �� Y�r+�s ����3 ���.I ����������'1���� �` .'+q�' �°yi�;�"�`a�iF�,��<irv ';��;=1� ti <br /> FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTI�R <br /> TYPE FL FL TYPE FL FL <br /> Water Closet Floor Drains �, <br /> Lavatory Sewer Ejector <br /> Bathtub Laundry Tray <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Disposal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Miscellaneous <br /> ���'�?�7''44 ���'�*t�y!1��/'�k�}}..i.'�.:.1���1�'lzi�.,������41�1 l��F�t��'�.;3 ��f t �r��€',�, 4 �, � � <br /> � ��� : �' t� ��� � �'�AS��'���n,2��S�A`k�,�TAT'�E; ��,�"�a'� "�,+��S��t'{, ', <br /> 0 Yes,this section applies <br /> The replacement of only one Residential fixture or aopliance that meets all three of the following <br /> requirements: <br /> 1. Does not require modification to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludin�the cost of the fixture or appliance: and <br /> 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. � <br /> Skip next section,if this applies; Cost of Permit $ 15.00 <br /> Sta.te Surcharge $ 5.00 <br /> Mail-In Fee(If Applicable) $ 2.00 <br /> Total Permit Fee $ <br /> (Permit Fees Continued On Next Page) <br /> 2 <br />